You may be surprised at how much of a role your big toe plays in your running performance. It helps you keep your balance and provides power on the push-off.
When your big toe is injured, you can be sure that your running performance will be affected. In the case that your toe’s range of movement is severely limited—like hallux rigidus—you may wonder if you’ll ever be able to run again.
We have good news—yes, you can, and will, run again. We advise that you read through this information, including our tips for running with hallux rigidus, to make sure that you’re doing it as safely as possible.
What Is Hallux Rigidus?
Hallux rigidus is the medical term for a common type of progressive arthritis that affects the base of the big toe.
This arthritic condition is also called stiff big toe—the literal meaning of hallux rigidus—big toe arthritis, or turf toe.
Hallux rigidus breaks down the protective layer of cartilage covering the end of your big toe bones. As a result, the space between the bones in your toe becomes narrower.
As the condition progresses, you’ll find it increasingly harder to bend your toe, until the joint becomes stiff and inflexible. This is also known as a “frozen joint”.
A frozen joint can make everyday tasks like walking, climbing stairs, or any form of weight-bearing exercise painful and challenging.
It can also cause you to develop other foot conditions, such as bone spurs or bunions that form on top of the affected joint.
While the cause of hallux rigidus may not be clear, several risk factors can increase your likelihood of developing the condition.
The most common cause is overuse of the big toe joint. This can happen through repetitive movements, like bending or squatting, which places the big toe joint under a lot of pressure.
The repetitive motion of running too often or too far can also lead to overuse of the joint, causing hallux rigidus.
Other than overuse, an injury to the big toe joint where you’ve sprained the joint or stubbed your toe can contribute to developing the condition.
The following risk factors can increase your risk of developing hallux rigidus:
- Inflammatory diseases like gout, rheumatoid arthritis, or osteoarthritis
- Faulty foot mechanics, like fallen arches, or a long or elevated metatarsal bone
- Your family history, especially if a family member already has it
- If you overpronate excessively, which places stress on the big toe
Often the first sign of the condition is when you feel pain in and around the joint while you’re walking, running, or bending.
The pain will feel worse when you try to bend the toe, and you may notice a grating or grinding feeling in the toe joint. This can also be accompanied by stiffness, inflammation, swelling, and redness of the big toe joint.
In the early stages, the pain can be mild and temporary. But as the condition progresses, it becomes a deep, constant, aching pain.
As the range of motion of your toe decreases and you can no longer flex it, you may find yourself unconsciously compensating for the lack of mobility. This can lead to problems with your lower back, hips, or knees, making it painful to walk, stand, or bend.
Cold, damp weather can also affect the toe joint, increasing both pain and stiffness.
You can also develop a bony growth—known as a dorsal bunion—on the top of your joint. Not only can this make it difficult to find shoes that are comfortable to wear, but you may feel a sharp pain on your toe when wearing them.
How Does a Stiff Big Toe Affect Your Running?
Your big toe plays a vital role in running, especially during the push-off phase of your gait, by transferring your weight forward. This helps to provide momentum for you to move in that direction.
When your foot is in contact with the ground, your big toe stabilizes your foot, supports the arch, and regulates the degree of foot pronation. It also helps distribute impact evenly and transfers energy efficiently during the push-off phase.
However, your range of motion is compromised when you have hallux rigidus, and your body will try to compensate for the lack of mobility.
You may find that you unconsciously change your stride, causing your feet to land or roll onto the outside of your foot so that you can avoid pushing off of your big toe.
This can lead to inefficiencies or injuries as your foot tries to push-off using your smaller toes. When this happens, it results in a “choppier,” less powerful stride that can also cause pain in other parts of the body, like your ankle, heel, knee, hip, and lower back.
The limited range of motion in your big toe can also limit your ankles’ range of motion. Your body then naturally leans forward to compensate and shortens your stride to protect the joint.
Your lower leg muscles then take on the excess strain. They’re not designed to bear the excess load, which causes a breakdown in your kinetic chain.
This can lead to:
- Early muscle fatigue
- Extremely tight calves or calf strains
- Runner’s knee
- Plantar fasciitis
- Achilles tendonitis
- Posterior tibialis tendonitis
- Metatarsal stress fractures
- Knee, hip, and lower back pain
Can You Run With Hallux Rigidus?
Fortunately, you won’t have to hang up your running shoes!
You can still run with hallux rigidus, but you may need to make a few changes that will help protect your big toe joint while you run.
With that being said, you should consult your doctor or podiatrist if your symptoms get worse while you run.
Tips for Running With Hallux Rigidus
If you suffer from hallux rigidus, following these tips will help you stay pain-free and keep your range of mobility good enough to run comfortably.
If you haven’t started developing symptoms, but you’ve had a big toe injury in the past, or you have a family history of arthritis, taking these steps can slow the progression of the condition.
Wear the Right Shoes
The first step to running pain-free is to get the right footwear! Switch to running shoes that have a supportive midfoot and a rocker bottom with a thick and stiff outsole.
The stiff outsole will help to limit the movement of your big toe joint. At the same time, the rocker bottom makes the push-off easier on your toe joint by letting your foot “roll” into the push-off phase.
This helps to reduce the amount of strain placed on the toe joint, allowing the shock and movement to be absorbed by the shoe instead.
Switch to Running on Softer Surfaces
Running on unforgiving surfaces can place extra strain on your big toe. Uneven terrain places more impact on every step.
Choosing to switch to a softer, more forgiving running surface can help to reduce the symptoms and make running easier.
If you can, do your training runs on grass, dirt, synthetic running tracks, or a treadmill with excellent shock-absorbing features.
Not only will this limit the shock to your big toe joint, but it will also protect your other joints and reduce your chance of injury.
If you run competitively, you may want to switch from road races to trail runs or track runs in order to ensure that you’re always on a softer, more forgiving surface that will be safer for your affected toe.
Tape Your Big Toe
You can tape your big toe before you go for a run to help limit the range of motion, reduce the load on your toe, and reduce pain.
Try to use rigid tape instead of flexible tape. This will help to keep the toe firmly in place so you don’t have to worry about it moving.
You should also make sure that your shoes have a wide toe box so that the tape doesn’t rub against your shoe and come undone.
Cut a piece of tape about 8 inches in length. Split this in half lengthways, making 2 thin strips of about 8 inches each.
Take one strip and stick the center of the tape firmly on the big toe joint. Then take the piece of tape that’s on the outside of your foot and wrap it around your toe and slightly downwards, so the next anchor point is the base of the toe underneath your foot.
From there, run the remaining tape down your foot towards the arch. The tape should form a question mark shape.
Repeat these steps with the other side of the tape. Anchor it behind and below your big toe joint, and stick it down on top of the original piece, running downwards towards the arch.
This should sufficiently limit the movement of your big toe.
You can use a Morton’s extension insert to help reduce excess motion in the big toe. This is a stiff insole that has a support piece underneath the big toe, preventing it from flexing and causing pain.
If you have altered your gait to prevent placing pressure on your big toe, an orthotic may help. You can get store-bought orthotics that provide support for the arch and heel, or you can opt for a custom orthotic that will be personalized for your feet.
You should still consider adding a Morton’s extension insert to your shoes even if you are using an orthotic. They should be able to be used together since the insert is very thin.
Stretch the Joint
Gently stretching your big toe joint can help to keep it as mobile as possible and reduce pain while you’re running.
Try to incorporate these toe stretches and exercises at least four or five days a week. You should do 8 to 10 repetitions for 2 sets of active movement exercises, and hold stretches for 20 to 30 seconds for 2 to 3 repetitions.
- Towel Curls
- Toe Pulls
- Toe Splays
- Marble Pickups
- Resisted Toe Flexion
- Toe Salutes
- Toe Press, Point, and Curls
As well as stretching your toe on a daily basis, you may want to visit a physiotherapist as they will be able to help you to increase the range of motion safely.
A physiotherapist will not only help you to learn which exercises are the best for your toe, but they will also be able to offer alternative therapies to help your toe, including:
- Soft-tissue massage
- Traction options
- Interferential current
Treatment After Running With Hallux Rigidus
Rest Your Feet
Resting your feet will allow your toe joint to recover from the activity. If you don’t allow your feet adequate time to rest, you may be placing your toe joint under even more risk of overuse, leading to increased pain and a more limited range of motion.
Icing your toe can help to relieve pain and bring down swelling and inflammation. You should apply ice—wrapped in a cloth—for 15 to 20 minutes, 3 to 4 times a day, including just after you return from a run.
You can use over-the-counter nonsteroidal anti-inflammatories to reduce the pain and swelling. However, you should ask your doctor about this before using them, and they should only be used in cases of severe pain and not on a daily basis.
Alternatively, buying joint supplements such as glucosamine-chondroitin sulfate can help to reduce symptoms of osteoarthritis, and may have a positive effect on hallux rigidus.
Soak Your Feet
To relieve aches and inflammation, you can try a contrast bath. You will need to fill two tubs, one with lukewarm water and one with hot water—make sure it’s not hot enough to burn you.
Place your foot in the hot water tub for 30 seconds. Then, take it out and place it immediately into the cooler water. This can help to relieve inflammation and reduce pain in your toe.
Continue to alternate this way for 5 minutes.
If you have tried every form of treatment, but your symptoms have not improved, your doctor may recommend corticosteroid injections into your big toe joint.
They can help to relieve pain, but should be used as a last resort when all other options have been exhausted.